Healthcare Provider Details

I. General information

NPI: 1649197047
Provider Name (Legal Business Name): CHUKWUDI D UWALOR OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 NEWPORT DR STE A
FOREST HILL MD
21050-1758
US

IV. Provider business mailing address

PO BOX 179
FOREST HILL MD
21050-0179
US

V. Phone/Fax

Practice location:
  • Phone: 410-838-6808
  • Fax: 410-838-2511
Mailing address:
  • Phone: 410-838-6808
  • Fax: 410-838-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10775
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: